Provider Demographics
NPI:1215231527
Name:CLAUDIA TAYLOR DC PC
Entity Type:Organization
Organization Name:CLAUDIA TAYLOR DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-286-5858
Mailing Address - Street 1:366 S COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11719-9768
Mailing Address - Country:US
Mailing Address - Phone:631-286-5858
Mailing Address - Fax:631-286-5859
Practice Address - Street 1:366 S COUNTRY RD
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11719-9768
Practice Address - Country:US
Practice Address - Phone:631-286-5858
Practice Address - Fax:631-286-5859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-29
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX003511-1261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center